ASHP Statement on the Pharmacist’s Role in Substance Use Disorder Prevention, Treatment, and Recovery

Topic: Risk, prevention and care in population studies

In both adolescents and adults with SUD, approximately 95% did not perceive a need for treatment.1 Although drug-related overdose deaths are declining, over 98,000 American deaths occurred in 2024.2 The vast majority of drug overdose deaths involve unregulated opioids, and in 2022 roughly 6.1 million people had an opioid use disorder (OUD) in the prior year.1 Costs related to the consequences of substance use the United States were nearly $1.5 trillion in 2020, up 37% from $1.07 trillion in 2017.3,4 Unhealthy substance use and untreated SUD may increase the risk of significant comorbid chronic health conditions, death from overdose, or suicide. Xylazine, a veterinary tranquilizer, is sometimes combined with opioids, which results in a deep sedative effect, and xylazine has been found in the US illicit drug supply, with increasing presence across the US from 2020 to 2021.10 Xylazine use is linked to chronic, infected wounds on extremities that often occur away from injection sites, sometimes requiring amputation.10,11 Access to SUD care is inadequate and unevenly distributed. Some resulting OTP updates include allowing methadone take-home doses, allowing telephone or video telehealth (e.g., telemedicine) for MOUD treatment initiation without a prior in-person evaluation, and discouraging rigid reliance on toxicology testing results. Research demonstrates that telemedicine is as effective as office-based treatment and is associated with higher patient satisfaction and lower treatment discontinuation rates.18–23 A stepped care model for MOUD has been described as a means of improving access to MOUD with a “no wrong door” approach to care,24 providing care where patients prefer to be treated. When a healthcare worker needs SUD treatment, it is imperative that comprehensive, evidence-based, and stigma-free treatment and recovery services are available.31,32 Stigma remains a significant driver of both SUD and overdose. Data suggests negative attitudes toward individuals with prescription-based OUD exceed those reported for other medical conditions, including mental illness.33 Substance use is featured in media representations of impoverished populations,32 and US drug policies disproportionately target marginalized groups.34,35 Stigma and discrimination experienced by LGBTQIA + individuals have been associated with higher drug overdose rates.35 Stigmatizing attitudes among health professionals are common, and this is a known barrier for access to MOUD.36–40 Legi

Key findings

• In both adolescents and adults with SUD, approximately 95% did not perceive a need for treatment.1 Although drug-related overdose deaths are declining, over 98,000 American deaths occurred in 2024.2 The vast majority of drug overdose deaths involve unregulated opioids, and in 2022 roughly 6.1 million people had an opioid use disorder (OUD) in the prior year.1 Costs related to the consequences of substance use the United States were nearly $1.5 trillion in 2020, up 37% from $1.07 trillion in 2017.3,4 Unhealthy substance use and untreated SUD may increase the risk of significant comorbid chronic health conditions, death from overdose, or suicide.
• Xylazine, a veterinary tranquilizer, is sometimes combined with opioids, which results in a deep sedative effect, and xylazine has been found in the US illicit drug supply, with increasing presence across the US from 2020 to 2021.10 Xylazine use is linked to chronic, infected wounds on extremities that often occur away from injection sites, sometimes requiring amputation.10,11 Access to SUD care is inadequate and unevenly distributed.
• Some resulting OTP updates include allowing methadone take-home doses, allowing telephone or video telehealth (e.g., telemedicine) for MOUD treatment initiation without a prior in-person evaluation, and discouraging rigid reliance on toxicology testing results.
• Research demonstrates that telemedicine is as effective as office-based treatment and is associated with higher patient satisfaction and lower treatment discontinuation rates.18–23 A stepped care model for MOUD has been described as a means of improving access to MOUD with a “no wrong door” approach to care,24 providing care where patients prefer to be treated.
• When a healthcare worker needs SUD treatment, it is imperative that comprehensive, evidence-based, and stigma-free treatment and recovery services are available.31,32 Stigma remains a significant driver of both SUD and overdose.

Why it matters

This statement describes the pharmacist's role in substance use disorder prevention, treatment, and recovery, including overdose deaths, opioid use disorder, and access to care. It does not report any treatment, cure, or prevention for Alzheimer's disease.

Study details

• Study designlongitudinal study
• Effect size17.1%; 23.6%; or 12.8
• Evidence strengthModerate

Read the original

• DOI: 10.1093/ajhp/zxag024
• PubMed: 41711667
• Original source →

May need a subscription OpenAlex found no free copy of the full text (checked 6 Feb 1020), so the publisher may charge for it. The PubMed abstract is free.

@article{jorgenson2026-41711667,
  author  = {Jorgenson, Terri L. and Tran, Tran H and Bratberg, Jeffrey P.},
  title   = {{ASHP Statement on the Pharmacist’s Role in Substance Use Disorder Prevention, Treatment, and Recovery}},
  journal = {American Journal of Health-System Pharmacy},
  year    = {2026},
  doi     = {10.1093/ajhp/zxag024},
  pmid    = {41711667},
  url     = {https://doi.org/10.1093/ajhp/zxag024}
}

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